Provider Demographics
NPI:1396590196
Name:WEISS, STEPHANIE (RMHC-I)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:
Last Name:WEISS
Suffix:
Gender:F
Credentials:RMHC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 DELMAR WAY APT 302
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-3358
Mailing Address - Country:US
Mailing Address - Phone:203-417-6965
Mailing Address - Fax:
Practice Address - Street 1:805 DELMAR WAY APT 302
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-3358
Practice Address - Country:US
Practice Address - Phone:203-417-6965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL23722101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health